Note: 1.

Please indicate your latest compensation details relating to salary, daily allowances, target incentive &
2. Please attach relevant supporting documents, which would include most recent payslips, increment le
3. Please save the file in your name.

Name
Present Organisation Name
Present Designation
Present Headquanter
Components INR. Per Month INR. Per Annum
Basic Salary ( + Dearness Allowance, if any) -
Provident Fund -
ESI Contribution -
Gratuity -
Total (A) 0 0
House Rent Allowance -
Education Allowance -
Leave Travel Allowance -
List others as applicable -
-
-
-
-
-
-
Total (B) 0 0
Annual Fixed Compensation (A+B) 0 0

Sales Incentives at Target (assuming achievement at 100% for monthly, quarterly,

half-yearly and yearly targets)

Daily Allowances: For meeting fields expenses

Headquarter allowance per day
Ex- Headquarter allowance per day
Outstation Allowance per day
Outstation Lodging/Hotel Stay Limit per day, if over & above
Outstation Allowance
Fuel Reimbursement : per km
Any other Daily Allownace (please specify)

Monthly Reimbursements : As per company policy

Monthly Limit for Mobile & Internet
Monthly Limit for courier & stationery
Vehicle Maintenance Allowance
Metro Allowance, if applicable
Any other (please specifiy)

Benefits
Group Life Insurance
Accident Insurance
Hospitalisation Insurance - Indicate extent of coverage
Leave per annum (indicate Earned(privilege)/Sick/Casual
ances, target incentive & monthly reimbursements
nt payslips, increment letter, appointment letter, etc.

Comment